Shelby Mattison, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11947 Issued in MN

Practice address

800 E 28TH St
Minneapolis, MN 55407-3723

Phone

(920) 716-2274

NPI assigned

Mar 10, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shelby Tarr Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1912582024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9473 JEWEL LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "920-716-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "SHELBY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "TARR",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justin Matthews, MA
• Sarah Matthiesen
• Abimbola Adenike Matti, CNP
• Margaret Marie Mattingly, LICSW, LP
• Michael Mattingly, DDS
• Adam Reed Mattox, D.O.
• Amanda Mattson, PA-C
• Ben Andrew Mattson, LPCC
• Emily Mattson, PHARMD
• Jordan Mattson, MD

• Physical Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.